Issue link: https://tmcpulse.uberflip.com/i/610185
t m c » p u l s e | d e c e m b e r 2 0 1 5 28 Even in the wake of concerted efforts throughout the city to house its residents—the number of homeless people residing in shelters or in public spaces in the Houston area has report- edly dropped 46 percent in the past four years—there are still significant strides to be made. According to Buck, emerg- ing barriers to homeless care, such as day shelter services provided only for individuals who are defined as "chron- ically" homeless, pose the potential to exclude large swaths of the population. "My worry is that the people who are most at risk, those that are seriously mentally ill, are the ones that we're not reaching because they're unable to make it to our clinics," he said. "In medicine, we're taught that you 'build a clinic and they will come,' but it's the people that aren't coming to our clinics that we need to target. We need to make them more accessible to us, and vice versa." Seeking to engage individuals who might otherwise slip through the cracks, that concern spurred Buck and his colleagues to action. In conjunction with several of the HOMES Clinic's medical students, HHH and Star of Hope Mission, and leveraging advice from the Michael E. DeBakey VA Medical Center, they've worked to develop a local street outreach team. With stethoscopes dangling from their necks and armed with hygiene kits containing toothbrushes, shaving cream, soap, socks and other essentials, the students have already walked the streets of downtown Houston on several occasions. "We wanted to develop a program here where the students could meet people, on the street, on a Thursday afternoon, and follow up with them and develop continuity of care for the Sunday clinic," said Buck. "I think the heart of true health care is engaging people in a care plan of their own device, that reflects their own goals— not ours—to help them reach their potential. We don't provide medicine on the street because our goal is to engage people in care and to get them to the activation point where they're willing to fulfill their own health care needs." Tapping into a broader cul- tural conversation, seven students from UTHealth and Baylor recently returned from a trip to this year's annual International Street Medicine Symposium (ISMS) in San Jose, California. An educational event dedicated to the health care of unshel- tered homeless populations—known as "rough sleepers" throughout the community—the ISMS offered a slate for homeless health care experts from around the globe to present clinical topics, research outcomes, and best practices related to street medicine. "The street outreach team is really changing our paradigm," said Kenneth D. Eakins, outreach case manager for Star of Hope Mission. "It's allowing us to see the need that's around us, and how we're able to partner and partici- pate together as a team with a common purpose. Together, we can truly make an impact and begin to transform lives and gather greater resources for our clients." For students like Chesnokova, conveying medical expertise, empathy and conviction in her mission, her last question to her patient unfurls a blank page of possibility and progress. "We're going to make you an appointment for this Sunday—do you think you'll be able to make it?" THE HOMES (HOUSTON OUTREACH MEDICINE, EDUCATION AND SOCIAL SERVICES) CLINIC IS A MULTI-INSTITUTIONAL, MULTI-DISCIPLINARY, STUDENT-RUN, FREE CLINIC FOR THE HOMELESS PEOPLE OF HOUSTON.